The effect of using denture adhesives on patient satisfaction with complete dentures; a randomized clinical trial.

BACKGROUND: Denture adhesives can be useful in improving patients' satisfaction with complete dentures. However, comparison clinical trials are lacking. The purpose of this randomized clinical trial was to assess the satisfaction of edentulous patients and their oral health impact profile when provided with 3 types of denture adhesives. METHODS: Sixty-four completely edentulous patients seeking complete dentures for their first time were randomly divided into 3 groups. Each group received a set of complete dentures, which were adjusted at review appointments until participants reported no complaints. After 1 month of using the dentures, participants rated their overall satisfaction and their satisfaction regarding comfort, retention, stability, and efficiency of mastication and speech on a 100-mm visual analog scale (VAS). Participants also filled out the oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire. Each group was then given 1 type of denture adhesive to use. Group C received Corega Ultra denture fixative cream (GlaxoSmithKline), Group O received Olivafix (Bonyf), and Group S received Sea. Bond adhesive strips (Sea.Bond). Mann-Whitney U test was used to analyze the differences in VAS scores before and after using the adhesive within each group and Wilcoxon-signed rank test was used to compare OHIP scores and total OHIP values before and after using the adhesive within each group (p = 0.05). Furthermore, Kruskal Wallis test was used to compare the differences before and after using the adhesives in VAS and OHIP values between the 3 groups. RESULTS: Significantly higher VAS values were detected in all groups and significantly lower values for many OHIP items in addition to total OHIP values were detected in all groups after using the adhesives (P < 0.05), except for the ease of cleaning for Group O and Group S (P > 0.05). No significant differences were found in VAS and OHIP values between the 3 groups (P > 0.05), except for the ease of cleaning which was significantly different between Group C and Group S (p = 0.005). CONCLUSIONS: Using denture adhesives for completely edentulous patients resulted in higher patient satisfaction as indicated by higher VAS scores as well as improved quality of life as indicated by lower OHIP-EDENT scores after using the adhesives. These improvements were not dependent on the type of adhesive, except for ease of cleaning as adhesive strips were easier to clean than paste type adhesives. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (ID: NCT05496283) on 11/08/2022.

The effect of different denture cleansing solutions on the retention of polyetheretherketone locator attachments.

PURPOSE: Prosthetic cleansing solutions have been reported to cause retention loss in implant locator attachments due to the chemical alterations of these attachments. This study aimed to investigate the effects of different denture cleansing solutions on attachments with different retention values. MATERIALS AND METHODS: In this study, 160 polyetheretherketone locator attachments were divided into 4 groups according to their attachment retention values (yellow, pink, clear, and violet). Forty attachments from each group were soaked in four different cleansing solutions (n = 10). The attachments from the four groups were immersed in water, sodium hypochlorite, Corega, and Protefix solutions for a period equivalent to 6 months, according to the manufacturer's recommendations. The locator attachments were then subjected to testing using a universal testing machine. Maximum load to dislodgement according to different solutions was evaluated by one-way ANOVA test. Statistical significance was set at p < 0.05. RESULTS: The effect of denture cleansing solutions on the retentive values of attachments was statistically significant (p < 0.001). Among all cleansing solutions, the highest retention value was found in the violet attachments, and the lowest retention value was found in the yellow attachments. The lowest retention value (0.72 ± 0.05 MPa) was observed when the yellow attachments were immersed in Protefix solution, and the highest retention value (1.96 ± 0.15 MPa) was observed when the violet attachments were immersed in the Corega solution. CONCLUSION: For different colored attachments, different cleansing solutions can be suggested to patients.

Retention of bar clip attachment for mandibular implant overdenture.

OBJECTIVES: The aim of the present study was to evaluate the retention and loss of retention after fatigue testing at different time intervals between two types of bar clip materials (digitally designed PEEK bar clip and regular Nylon bar clip). MATERIALS AND METHODS: An epoxy model was constructed for a completely edentulous mandible. Two implants were placed according to prosthetically driven implant placement by a computer-guided surgical stent. Bar clips were digitally designed, 3D printed, and pressed into Poly Ether Ether Ketone (PEEK). Pick up of PEEK and nylon clips was performed on the dentures fitting surface using self-cured acrylic resin. Each study group was subjected to an insertion and removal fatigue test simulating 3 years of patient usage. Retention values were recorded using the universal testing machine at initial retention and after 1, 2, and 3 years of simulated usage. For proper sample sizing, 24 models and dentures (12 for each group) were used. An independent sample t-test and repeated measures analysis of variance were used to compare the data. RESULTS: There were statistically significant differences in retention between the PEEK and nylon bar clips at the beginning of the experiment (p = 0.000*). But after 3 years of simulated use, there was no significant difference in retention between the test groups (p = 0.055, NS). After 3 years of simulated use, the retention of PEEK clips decreased by - 58.66% recording 17.37 ± 1.07 N, while the retention of nylon clip increased by + 2.99% recording 16.56 ± 0.88 N. CONCLUSION: The digitally designed PEEK clip showed comparable retention results to the nylon clip after 3 years of simulated use. CLINICAL RELEVANCE: Maintenance of bar attachment with PEEK clip offers a clinical solution after the wear of normal plastic clips, which is a cheap solution that is easily fabricated and picked up into the denture. Digital fabricated PEEK bar retentive inserts can be used in cases of bar attachment wear.

Frictional wear of stud implant overdenture abutments after 2 years of in vitro simulated function.

Progressive wear of the components of an implant-supported overdenture can lead to loss of denture retention, which affects masticatory function and the patient's quality of life. The primary objective of this in vitro study was to investigate frictional wear in a type of commonly used abutment and thereby estimate the general clinical lifespan of a typical stud abutment and establish a protocol for replacement. Therefore, simulated overdenture insertions and removals equivalent to 2 years of overdenture use were performed to evaluate surface changes in the metal stud abutment component. A digital caliper, scanning electron micrographs taken at ×500 magnification, and profilometer data were used to determine the wear rate and surface roughness. A universal testing machine was used to measure retention load force with 4 clear male nylon inserts (5.0-lb retention) during 2160 insertion and removal cycles. The results showed that with a 6-month replacement program for clear male nylon inserts, the frictional wear on the titanium nitride coating of abutments placed at a 0° position resulted in a decrease of up to 50% in removal forces of the inserts after a simulated 2 years of wear. The combination of wear of the titanium nitride coating and the decrease in retention load values suggests that stud abutments should be replaced after 2 years of use for optimal retention.

Changes in denture retention with denture adhesives and oral moisturizers for the oral cavity: an in vitro study.

BACKGROUND: It is difficult to maintain complete dentures during meals in place. This in vitro study aimed to assess changes in denture retention between rest and function using denture adhesives and oral moisturizers in an oral cavity model. METHODS: The following test samples were applied between the palatal plate and the edentulous jaw ridge model: denture adhesive, denture adhesive for dry mouth, oral moisturizer, and denture moisturizer. The retentive force was measured under two conditions: at rest while immersed in water and during function with a 2.5-kg load applied. The plate was pulled perpendicular to the occlusal plane and the retentive force was measured using a digital force gauge. RESULTS: Under dry conditions, denture adhesive for dry mouth and oral moisturizer had a significantly higher retentive force than denture adhesive and denture moisturizer. After 30 min of immersion in water, the retentive force of the denture adhesive increased while that of the oral moisturizer decreased. After 30 min of function, the retentive force of the denture adhesive and denture adhesive for dry mouth remained high, while that of the oral moisturizer and denture moisturizer significantly decreased. Between rest and function, the retentive force of the denture adhesive and denture adhesive for dry mouth was high, and that of the oral moisturizer was low. CONCLUSIONS: Immediately after use, denture adhesive for dry mouth exhibited high retentive force, but retention gradually decreased due to its water content.

Assessment of Retention of CAD-CAM Milled PEKK vs PEEK Double Crown-retained Removable Partial Dentures: A Randomized Clinical Trial.

AIM AND OBJECTIVE: To assess and compare the dislodging force of double crown-retained removable partial dentures (RPDs) made from polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) at insertion (baseline) and one year after clinical functional use. MATERIALS AND METHODS: A total of 18 patients with maxillary symmetrical Kennedy class I with the second premolars being the last standing abutment were selected. The patients were randomly assigned into two groups according to the materials used for the construction of the double crown-retained RPD. Group I: Double crown-retained RPDs were made from PEKK. Group II: Double crown-retained RPDs were made from PEEK. For both groups, the primary copings were made from zirconia (ZrO2). The dislodging force was measured using a digital force gauge at baseline and one year after clinical functional use. An independent t-test was used for intergroup comparisons and a paired t-test for intragroup comparisons. RESULTS: when comparing both groups at baseline, there was no significant difference between the two groups, but after one year, Group I had a significantly higher dislodging force value than Group II. Individually, there was an increase in dislodging force in both groups one year after clinical functional use, which was statistically significant for Group I. CONCLUSION: After clinical functional use, double crown-retained RPDs made from PEEK in combination with ZrO2 primary copings demonstrate a minimal increase in dislodging force, while those made of PEKK demonstrate a significant increase in dislodging force. CLINICAL SIGNIFICANCE: All patients were satisfied with the retention and esthetics of their dentures. Polyetherketoneketone double crown-retained RPDs demonstrate better retention one year after clinical functional use.

Patient satisfaction with ball and Equator attachments for single-implant mandibular overdentures: A short-term randomised crossover clinical trial.

BACKGROUND: Retention and stabilisation of a single-implant mandibular overdenture (SIMO) are influenced by the biomechanical properties and clinical performance of the attachment system. PURPOSE: To compare clinical and patient-reported outcomes following the use of two retention systems, a ball and a stud-type Equator attachment used for SIMO. MATERIAL AND METHODS: Eighteen fully edentulous participants were treated with a SIMO opposing to a maxillary complete denture. They received two retentive attachments (ball and Equator) in alternate periods (sequences A-B and B-A) and outcomes were assessed after the 1 week (initial) and 3 months (final) periods. In the final assessment, patients were also asked about their preferred retention system. RESULTS: Compared with baseline, there was an improvement in patient satisfaction using both attachments, whilst no difference was observed between initial and final periods. Similarly, no significant differences were observed when comparing the ball and Equator at the initial (P = .330) and final (P = .08) periods. The multilevel mixed-model analysis revealed that the patients' satisfaction was predicted only by their satisfaction with dentures before implant placement. Although no significant difference was found between attachments regarding patient preference, this may be biased by the sequence of attachment use, which suggests that a learning effect might be present in this crossover study design. CONCLUSION: The use of a single midline implant to retain a mandibular overdenture significantly improves patient satisfaction irrespective of the attachment used, but patients' preference for the second treatment suggested a learning effect in this study.

An Alternative Incorporation Technique for Minimizing Complications in Attachment-Retained Implant Mandibular Overdentures: Technical Report.

The present technical report aimed to display an alternative incorporation method for ball/stud attachments in mandibular implant overdentures (MIO) to prevent or minimize metal housing debonding and attachment malpositioning. Precoating of metal housings with auto-polymerizing acrylic resin (AAR) and fabrication of straight AAR bars onto metal housings for optimal parallelism were used as new techniques. The glossy flat surfaces of metal housings (matrices) were sandblasted and precoated with a thin layer of AAR in the laboratory. Straight acrylic resin bars (3 cm long and 3 mm in diameter) were obtained and attached to these flat metal housing surfaces using a surveyor. The metal housings carrying the AAR bars were then placed intraorally onto ball/stud attachments, accurately positioned parallel to each other, and perpendicular to the long axes of implants and bound to the MIO with AAR.

A Novel Functional Swallow Method to Establish the Posterior Palatal Seal during the Maxillary Edentulous Final Impression: A Case Report.

AIM AND OBJECTIVE: To propose an alternate, r eliable, and easy-to-use functional swallow method for establishing the posterior palatal seal. BACKGROUND: Accurate r egistration of the posterior palatal seal is crucial to the success of the maxillary complete denture. The conventionally used functional "Ah" technique may not be r eliable at times to record the posterior palatal seal, hence compromising the retention of the maxillary complete denture. Case description and technique: A 70-year-old female patient requiring complete dentures presented with an unusually tense soft palate during the phase of posterior palatal seal development. The soft palate did not relax and remained in a superior position when the "Ah" functional method was used to record the seal. The posterior palatal seal area could not be compressed sufficiently during border molding, preventing the formation of an adequate seal. Hence, a new functional technique was devised to relax and displace the soft palate for developing an effective seal. This case report describes a novel and reliable method of displacing the posterior palatal seal area with a low-fusing compound by utilizing the patient's functional swallow position. CONCLUSION: The functional swallow method can be used effectively as an alternative and reliable method to obtain a consistent posterior palatal seal. CLINICAL SIGNIFICANCE: The functional swallow method of developing the posterior palatal seal is simple, less demanding on the clinician, and can save chairside time. It also helps in an easy transfer of the demarcated posterior palatal seal area to the custom tray. The method lets the dentist be in charge of developing the seal rather than relying on the arbitrary cast scrapping by the technician. Also, the seal can be achieved by employing commonly used materials.

Using Electromagnetic Articulography to Measure Denture Micromovement during Chewing with and without Denture Adhesive.

PURPOSE: To study the effects of denture adhesive upon denture micromovements in three dimensions during the chewing of hard, sticky, and tough food items observed using a novel method involving an electromagnetic articulograph (EMA) speech research system. MATERIALS AND METHODS: Ten volunteers (mean age 60.9 ± 10.4 years) with fair- or poor-fitting complete maxillary dentures were enrolled. Chewing experiments were conducted using two treatments (adhesive or no-adhesive control) and three foods: carrots (hard), raisins (sticky), and processed meat stick (tough). Denture micromovement was measured through a novel application of a Northern Digital Wave EMA System. Three-dimensional denture position was captured during mastication using three sensors embedded into a replica denture for each subject. Following individual characterization of a "home" reference position, the Euclidean Distances from Home (DfH) were calculated for each recorded sample of the chewing experiments. The DfH at each sample represented the denture movement for that 1/100th of a second of the activity. The DfH data were then summarized as the mean DfH, the maximum DfH, and total distance traveled by the denture. Several thresholds were also analyzed, including the percent of time that the DfH ≥1.5 mm, ≥2.0 mm, and ≥2.5 mm. RESULTS: With adhesive treatment, the mean DfH of dentures during chewing was reduced by 26.8% for carrot, 30.3% for raisin, and 31.0% for meat stick, when compared with no-adhesive treatment (p < 0.001 for all comparisons). Similar results were also seen for the maximum DfH and total distance travelled endpoints across foods. For the threshold endpoints, adhesive treatment was associated with a statistically significant reduction in denture micromovements at all three thresholds across foods. At the threshold of DfH ≥ 1.5 mm, adhesive treatment was associated with a reduction in micromovement by 61.6%, 56.2%, and 70.0% with carrot, raisin, and meat stick, respectively (p ≤ 0.004 for all comparisons). CONCLUSIONS: Observations of denture movement using the Wave EMA System were able to differentiate systematically between adhesive treatment and no-adhesive treatment for denture micromovements during different chewing challenges. Use of adhesive was associated with statistically significant reductions in denture micromovements for hard, sticky, and tough foods as measured with both distance and threshold endpoints.

Randomized Clinical Study Comparing Three Experimental Denture Adhesives and Fixodent® versus No Adhesive.

OBJECTIVES: Denture adhesives can improve function, retention, stability, and bite force in well-fitting dentures. This single-center, randomized, five-arm, examiner-blind, crossover clinical study aimed to compare three experimental adhesives ("Adhesive 1," "Adhesive 2," "Adhesive 3") with slightly different formulations and a commercially marketed "Positive control" with a "No Adhesive" arm using incisal bite force measurements over 12 hours in subjects with a moderately well- to well-fitting maxillary denture. METHODS: Institutional review and informed consent were obtained and qualified subjects were randomly assigned to a treatment sequence. Prior to adhesive application, subjects were asked to bite on a transducer with increasing force until their maxillary denture dislodged (bite force measurement). This procedure was repeated at 0.5, 1, 3, 6, 9, and 12 hours after adhesive application, with results recorded electronically. Treatment differences in the area over baseline (AOB) were analyzed using an ANCOVA model. RESULTS: A total of 48 subjects completed the study. All experimental formulations showed statistically significantly higher bite force measurements compared to the No Adhesive arm at all time points (p < 0.0001 for Adhesive 1 and Adhesive 2 at all times; p < 0.003 for Adhesive 3 at all times). While numerical values for bite force favored the Positive control for the duration of the study, there were no significant statistical differences at any time point between Adhesive 2 and the Positive control, and only over three and six hours compared to Adhesive 1. However, differences favored the Positive control compared to Adhesive 3 at all time points. CONCLUSIONS: All denture adhesives gave statistically significantly better bite force AOB in moderately well- to well-fitting dentures compared to no adhesive. All denture adhesives tested were generally well tolerated.

Prevalence and Factors Associated with the Use of Denture Adhesives by Older Complete Denture Wearers.

This study investigated the prevalence and the factors affecting the use of denture adhesives (DA) by older complete denture wearers. One hundred patients were interviewed and clinically examined for dentures' retention, stability and occlusion. A total of 31% used DA on a regular basis or sometimes; 14% used DA on both dentures, 19% on the maxillary denture and 26% on the mandibular one. DA use on the maxillary denture was significantly associated with younger age (p=0.026) and lower frequency of dentures' use (p⟨0.005), while their use on the mandibular denture was associated with the lower frequency of dentures' use (p⟨0.05) and good retention and stability of the maxillary denture (p=0.007). Multiple logistic regression analyses revealed that the DA use on maxillary dentures was significantly associated with younger age (odds ratio=0.938, p=0.026), while their use on the mandibular one was associated with good retention and stability of maxillary denture (odds ratio=1.451, p=0.007). These findings suggested that patient-driven factors, such as patients' age and denture's use habits had more significant effect on DA use than the denture's technical characteristics. Those factors should be further investigated to guide dentists in personalised recommendations on DA use to improve denture patients' quality of life.

[Effect of a gel-type denture adhesive on unstimulated whole saliva and minor salivary gland flow rates and on subjective orofacial sicca symptoms]. / A mufogsorragasztó hatása a nyugalmi kevert és a kis nyálmirigyek szekréciójára, valamint a szájszárazság érzetére teljes lemezes fogpótlást viselokben.

INTRODUCTION AND AIM: To determine whether the continuous use of gel-type denture adhesives influence the unstimulated whole saliva, the palatal and labial saliva flow rates, and to assess the possible changes of subjective orofacial sicca symptoms. METHOD: 28 maxillary complete denture wearing patients (average age: 70 ± 10 years) were investigated. A gel-type denture adhesive was administered to the patients for regular use during the 3 weeks of examination. A questionnaire of 16 questions was used to evaluate subjective orofacial sicca symptoms. Unstimulated whole saliva was determined by the spitting method, palatal and labial saliva flow rates were measured by the Periotron® device with filter paper discs at the initial, first, second and third weeks. STATISTICAL ANALYSIS: The following tests were used: subjective values - χ2-test; flow rates - ANOVA, paired Student's t-test. RESULTS: According to the questionnaire, the ratio or severity of xerostomia did not change. A significant increase in the subjective feeling of "saliva thickness" could be detected (p = 0.027), but the other subjective parameters remained unchanged. Palatal saliva flow rates decreased significantly by week 3 (week 0: 4.21 ± 3.96 µl/cm2/min; week 3: 2.21 ± 2.30 µl/cm2/min; p = 0.024). On the other hand, there was no significant change in the unstimulated whole saliva (week 0: 0.37 ± 0.36 ml/min; week 3: 0.39 ± 0.35 ml/min) and labial saliva (week 0: 3.99 ± 3.75 µl/cm2/min; week 3: 2.58 ± 3.39 µl/cm2/min) flow rates. CONCLUSIONS: The regular use of denture adhesives did not influence xerostomia and the majority of subjective orofacial sicca symptoms, but may cause a subjective feeling of "increased saliva thickness" and reduce palatal minor salivary gland flow rates among complete maxillary denture wearers. Orv Hetil. 2018; 159(40): 1637-1644.

Effect of bar cross-section and female housing material on retention of mandibular implant bar overdentures: A comparative in vitro study.

AIM: The aim of this study is to evaluate the effect of different cross-sections of bar connecting two implants on the retention of mandibular overdentures with Hader clip or lined with heat-cured resilient liner as a housing material. The retentive values after simulated 1.5 years of service were also recorded. MATERIALS AND METHODS: Edentulous mandibular acrylic model was constructed with two dummy implants located in the canine region and connected with cast bar assembly. According to bar cross-section and anchoring method, four groups (n = 10) of identical overdentures were used as Hader bar/clip group (HCG), Hader bar/silicone liner female housing group (HSG), oval bar/silicone liner female housing group (OSG), and round bar/silicone liner female housing group (RSG). Each overdenture sample was subjected to simulated wear up to 2740 manual insertions/separations. The mean retentive forces were measured at the baseline and after every 500 insertions. The data were statistically analyzed using one-way analysis of variance. RESULTS: The present study demonstrated that all bar cross-sections showed a significant difference at the baseline (P < 0.05), but HSG showed greater initial retention compared to HCG, OSG, and RSG. OSG showed a significant higher retention after 2740 insertions (simulated five insertions/day). CONCLUSIONS: Within the limitation of this in vitro study and for a similar period of service, heat-cured silicone female housing for Hader bar could maintain greater retention for two-implant-retained overdentures than provided by conventional plastic clip after 1.5 year. The oval bar recorded reasonable initial retention values and maintained these values for 1.5 years of service.

Shortcomings of prosthodontic rehabilitation of patients living in long-term care facilities.

Removable dentures are a non-invasive, cost-effective prosthodontic solution for the reduced dentition. Their intended purpose is the rehabilitation of harmonious oral function and aesthetics on a long-term basis. The prevalence of removable dentures among patients of advanced age is high and the quality of the dentures is often poor. The aim of this study was to find the most important shortcomings of removable dentures and address the main targets for improving the quality of prosthodontic rehabilitation. The records from dental check-ups in Austrian residential homes were analysed retrospectively. Dental anamnesis questionnaires and data from the clinical examinations of 105 denture wearers were analysed. The functional condition and retention of 192 dentures had been assessed, as well as the impact of the dentures on the intra-oral tissues. Insufficient denture retention was very common, particularly in the lower jaw (56·0%). Problems with the masticatory function were reported by 26.7% of the denture wearers, 11·4% were dissatisfied with the denture aesthetics, and 4·8% had difficulties with phonetics. Traumatic ulcers were found in 18·1%. Cracks, broken pieces (6·3%) or missing denture teeth (2·1%) were rare. It may be assumed that the findings of the present study also apply to a great percentage of community-dwelling seniors. The most important issues in prosthodontic rehabilitation with removable dentures are denture retention and masticatory function. Regular dental check-ups, denture adjustment and, when necessary, relining can maintain the primary denture quality and prevent damages of the oral tissues caused by ill-fitting dentures.

New Clasp Assembly for Distal Extension Removable Partial Dentures: The Reverse RPA Clasp.

Several clasp types are used in distal extension removable partial dentures. In some cases the terminal abutments have only distal retentive undercuts that can be occupied by bar clasps; however, bar clasps may be contraindicated with no suitable alternative. This article presents a reasonable solution by introducing a new clasp design as a modification to the well-known RPA clasp. The design includes a mesial rest, proximal plate, and buccal retentive arm arising from the rest and extending to reach the distal retentive undercut.

Prevalence of impacted third molars: a radiographic study among a North African population.

INTRODUCTION: Third molars are the most commonly concerned teeth with the impaction. Impacted third molar (ITM) can be associated to various clinical pathologies Aim: To determine the prevalence of ITM, its pattern and associated affections in Tunisian patients. METHODS: The study reviewed panoramic radiographs of patients consulting the Fattouma Bourguiba University Hospital, Monastir (Tunisia). Orthopantomograms were analyzed to define the prevalence of ITM; its angulation, depth and relation with the anterior border of mandibular ramus. Associated pathologies were also assessed. RESULTS: Seven hundred and thirty patients were included (286 men and 444 women). The age ranged from 19 to 89 years. Half of the patients (50.3%) showed at least one ITM. The total number of ITM was 881 with a statistical difference between arches (respectively 34.3% and 65.7% in the maxilla and in the mandible). The most common number of ITM was two (35.4%). Level C of impaction was observed more frequently in the maxilla and level A in the mandible. The most common angulation was the vertical one for both arches. Seventy six percent of ITM were presented with class II in relation with the anterior border of mandibular ramus. There was no significant difference in the frequency of impaction between gender and sides. The number of ITM associated with pathological conditions was 199 (22.6%). The most frequently observed pathology was the distal caries on the second molars (11.7%) followed by the caries of the third molars (5.2%). CONCLUSION: The prevalence of ITM among Tunisian patients was high.

Complete denture rehabilitation for a patient with Parkinson's disease using clinical strategies: A case report.

OBJECTIVE: To present clinical strategies for prosthetic rehabilitation with complete dentures (CDs) of a Parkinson's disease patient. CASE REPORT: An 82-year-old patient sought the Department of Dentistry at UFRN, reporting retention dissatisfaction and hamper to the mandibular CD adaptation. Patient-reported a dry mouth sensation, and exhibited disordered mandibular movements, tremors, and resorbed mandibular ridge. Aiming retention and stability, double molding with zinc enolic oxide impression paste, neutral zone technique, and non-anatomic teeth were proposed as clinical strategies. At delivery, identification and relief in the supercompression areas were performed to facilitate the acceptance and use of the new dentures. CONCLUSION: The strategies promoted patient satisfaction regarding retention, stability, and comfort. This treatment may be considered for the rehabilitation of Parkinson's disease patients, favoring the adaptation process.

A randomized clinical study to assess the performance of a marketed denture adhesive in a model of food infiltration in healthy, edentulous adults.

OBJECTIVES: An optimized food infiltration methodology was utilized to assess the objective and subjective efficacy of a marketed denture adhesive regarding denture dislodgment and infiltration and perception of food particles under maxillary and mandibular dentures. A pilot study helped optimize methodologies before the efficacy study. MATERIALS AND METHODS: Participants were healthy adults (n =48 for both studies) with fair- to well-fitting and well-made full maxillary and mandibular dentures. In the pilot, groups were a denture adhesive applied in a conventional dabbed-on pattern, a denture adhesive applied in continuous strips, or no adhesive. In the efficacy study, groups were the Test denture adhesive (continuous strips pattern application) or no adhesive, employed in a crossover design. Food infiltration was investigated through measurement of peanut particle mass retrieved from under each denture (30-32 g chewed). No formal statistical testing was performed in the pilot. Statistical analysis in the efficacy study was performed using analysis of variance. Primary efficacy evaluation was combined peanut particle mass from both dentures. Secondary efficacy evaluations included peanut particle mass under separate dentures, participant-reported denture dislodgements, and awareness/rates of how bothersome peanut particles under dentures were. RESULTS: In the pilot, the median peanut particle mass was lower with either pattern application compared with no adhesive. In the efficacy study, peanut particle mass under combined dentures was lower with than without adhesive (geometric mean [product of values]: 5.56 vs. 29.13 mg) with a between-group geometric mean ratio (adhesive over no adhesive) of 0.19 (95% confidence interval: 0.12, 0.30) favoring the Test adhesive (p < .0001). Similar Test adhesive beneficial outcomes in both studies included significantly fewer denture dislodgements and awareness and how bothersome peanut particles under dentures were. Treatments were generally well-tolerated. CONCLUSIONS: These findings, including reduced peanut particle infiltration, fewer denture dislodgments, and lower ratings of bothersomeness, corroborate those studies investigating the benefits of denture adhesive in preventing food infiltration.

Effects of denture adhesives on denture retention and occlusal forces in complete denture wearers: A multicenter, randomized controlled trial.

PURPOSE: This study aimed to determine the effects of denture adhesives on denture retention and occlusal force in complete denture wearers in a multicenter, randomized, parallel-group controlled trial. METHODS: Two hundred edentulous patients wearing complete dentures were allocated to three groups: powder-type denture adhesive, cream-type denture adhesive, and control (saline solution). Denture adhesives and saline solution were applied to the dentures for 4 days. The retentive force of the dentures and occlusal force were measured using a force transducer occlusal force meter at baseline and after 4 days of intervention. In addition to between-group comparisons, subgroup analyses of denture retention and occlusal force were performed based on the level of difficulty of the edentulism treatment. The levels were ranked as I (easy), II, III, and IV (difficult). RESULTS: Cream-type denture adhesives significantly improved the retentive force of the dentures (P<0.01) and occlusal force (P<0.05), with no significant differences between baseline and post-intervention forces in the powder-type denture adhesive and control groups. In within-group comparisons, cream-type denture adhesives improved both the retentive and occlusal forces at Level II (P<0.05), and powder-type denture adhesives improved the occlusal force at Level II (P<0.01). CONCLUSIONS: Application of cream-type denture adhesives effectively improves the denture retention and occlusal force in complete denture wearers with a moderate degree of difficulty during edentulism treatment.